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City of Fridley
„
Water Denartment
. Address L5 ��� / �L �l ' � - _ _
.. Name 1 � �PY�e, � ; _._
Date — �� ; ..
Old Meter Number l ,,� � / �J � � '
Old Meter Reading �/� d�
� Replacement No. �'� � .
Replacement Reading � � :
� ; Replacement Make ��,���Y
•�. Remarks: L �� h,�
. S igned L�� __
� ����' INSTALLATIO�����
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GiYOF AUTOMATIC METER READER
FRIDLEY
Address���(� `-� �� ��
Name W,�-LZC"� l :Z.r,R.���
Date � �-��`� t�
Old Meter Number �
Old Meter Reading �"'� �
Replacement No. �dY\��Z�r���
Replacement Reading�
Replacement Make ,T�AQ'��r`'�
ERT# ���� �3 I{['�
Replacement ERT#
Remarks:
Signed:
(rI 1'�
��t�t f+�r S�r�it�: Ft�rt
.� �City€�f Fr��:y
F� �Ca: �1-12-�3 �t�: �"'13l�i��2
Tj�e� �a�eler Er# �jr:
. Watex ��t�: Wa�er�
Address: 6�2D 7TH 3T� . �1-�C�44
t�e: 3/75�1�9�1014�1 �'1�' {�ner: Sa�e
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- City of Fridley
Water Department
6431 University Avenue NE
Fridley,MN 55432
(763)572-3566
!/we hereby authorize the City of Fridley and/or its
employees to do what is necessary to repiace the water meter. !understand that the property owner
is liable far the water line from the main to the premise and all interiar plumbing. (Per City code
402.06) !alsa hold the City of Fridley and/its empioyees harmless for any damages that may occur
while doing this aperation. This to inc(ude,but not iimited to;vatves,piping,watls,floors or the curb
� stop bax and service line. I understand i am also required to obtain a permit prior to any work,if
necessary.
Final meter read�ng(old meter� � ( f��L��
r� �a� f-Z`��'�-z
Name: Address•
Phone Number: Date: ^��,
Signature:
Witness Signature: � x
�RiDLEY CITY CaDE
CHAPTER 402.WATER,ST�RM WAfiER,AND SANlTARY SEWER
ADMiNISTRATION
(Ref Ord No 113,464,565,566,6Z9,638,662,922,488, 1144,1156, 1191}
402,05. PERMIT FEE
Prior to constructing or repair of any water or sewer line connecting the existirtg municipal system and any house
or building for which the application is made,the owner or contractor shall be requi�ed to obtain a permit for such
connection,and shai!pay a permit fee as provided in Chapter 11 af this Code. After such conneetion has been
made,the Water and Sewer Department shail be notified. It shall be�nlawfu!to cover any connecting line untii an
inspection has been made and suct�connection and the work incident thereto has been approved by the City as a
proper and suitable connectian.
402.06. REPAIRS AND MAINTENANCE TO CONNECTlON
After tt�e initial connection has been made to the water service curb stop box or the sewer lead at the property
line or a water service or sewer lead has been extended ta the property line for connection,the applicant,owner,
nr the occupant or user of such premises shall be liable for al!repairs required t�any wate�iine and sewer lines
necessary for cannection of the premises from the main to the premises. If the property owner requests
maintenance service a�repairs be perFormed by the City,the property owner shall be charged for the costs of the �
mainfenance and/or repairs, including any necessary street repairs,at a rate set annually by an administrative ;
policy. tt shail be the responsib+lity of the applicant,owner,occupant or user to perform standard rnaintenance of
the sewer service line from the premises to the main including debris clearing or root cutting and to maintain the
water service curb stop box for operak�ility and at such height as wilt ensure that it remains above the finished
grade of the land or property. (Ref 638,1156, 1191)
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